Cost-utility analysis of an integrated genetic/epigenetic test for assessing risk for coronary heart disease

Epigenomics. 2021 Apr;13(7):531-547. doi: 10.2217/epi-2021-0021. Epub 2021 Feb 24.


Aim: New epigenetically based methods for assessing risk for coronary heart disease may be more sensitive but are generally more costly than current methods. To understand their potential impact on healthcare spending, we conducted a cost-utility analysis. Methods: We compared costs using the new Epi + Gen CHD™ test with those of existing tests using a cohort Markov simulation model. Results: We found that use of the new test was associated with both better survival and highly competitive negative incremental cost-effectiveness ratios ranging from -$42,000 to -$8000 per quality-adjusted life year for models with and without a secondary test. Conclusion: The new integrated genetic/epigenetic test will save money and lives under most real-world scenarios. Similar advantages may be seen for other epigenetic tests.

Keywords: DNA methylation; coronary heart disease; cost–utility analysis; economics; epigenetics; precision medicine.

MeSH terms

  • Adult
  • Aged
  • Coronary Disease / genetics*
  • Cost-Benefit Analysis*
  • Epigenesis, Genetic*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Risk Assessment